Individual
ALYSSA HEITKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
220 S VAN BUREN ST, ENID, OK 73703-5812
(580) 234-9355
Mailing address
35149 BIRDIE LN, AVON, OH 44011-3307
(440) 371-1966
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5442
OK
Other
Enumeration date
09/04/2023
Last updated
11/11/2024
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